Malaria remains a major public health issue in Burkina Faso and is endemic throughout the country. Eighty percent of the estimated 19 million residents of Burkina Faso live in rural areas, where they are at greater risk for poverty and poorer health than their urban counterparts. In 2014, the proportion of children infected with malaria parasites in rural areas was three times that of children living in urban areas. Malaria prevention and control activities are guided by a national malaria control strategy, which supports the long-term vision of eliminating malaria in Burkina Faso by 2030. The strategy includes support for vector control, seasonal malaria chemoprevention for children under five years of age, intermittent preventive treatment for pregnant women, case management, and behavior change communication.
With the US President’s Malaria Initiative (PMI) funding, IRS was included as a priority vector control strategy and has been implemented annually since 2018. PMI VectorLink conducted spray operations in Burkina Faso in 2018 in the district of Kampti, Solenzo and Kongoussi using pirimiphos-methyl CS and clothianidin; in 2019 in Kampti, Solenzo and Kongoussi using pirimiphos-methyl, clothianidin and deltamethrin/clothianidin combination; in 2020 in Kampti and Solenzo using clothianidin and deltamethrin/clothianidin combination; and in 2021 in Kampti and Solenzo using pirimiphos-methyl CS, clothianidin, and deltamethrin/clothianidin combination. The Kongoussi district was only sprayed in 2018 and 2019, and later removed as an IRS district due to security issues.
In year five (January 2022 – December 2022), the project will work in close collaboration with the Institute of Research on Health Sciences / Institut de Recherche en Sciences de la Santé (IRSS) and the NMCP to conduct activities in-country. Specific project activities will focus on entomological monitoring through IRSS, ITN durability monitoring through Population Services International (PSI) and the 2021 IRS impact evaluation through PATH.
The project will carry out the following activities:
Insectary and Laboratory Activities
- Determine the susceptibility level of the main malaria vectors, Anopheles gambiae s.l., to six insecticides recommended by the World Health Organization (WHO) for IRS or ITNs: namely permethrin, deltamethrin, alpha-cypermethrin, clothianidin, chlorfenapyr and pirimiphos-methyl. Susceptibility testing will be conducted nationwide in 12 sentinel sites (including regions with IRS and next generation ITNs).
- Where there is pyrethroid resistance, conduct WHO bioassays to determine whether use of the synergist PBO followed by exposure to the pyrethroid insecticides, deltamethrin and permethrin, restores mosquito susceptibility.
- Determine the intensity of insecticide resistance to deltamethrin, alphacypermethrin and permethrin using the WHO intensity assay in the same 14 sentinel sites.
- Conduct laboratory analysis of mosquito samples to determine species composition, presence of resistance mechanisms of the voltage gated sodium channel (kdr W & E) and Ace-1, blood-meal source, and infectivity with P. falciparum sporozoites.
- Conduct larvae collection for insecticide resistance testing in 14 nationwide sites.
- Conduct longitudinal monitoring of vector bionomics in 10 sites, including four in former IRS districts, four in adjacent unsprayed areas (which will have Interceptor G2 ITNs), and two in areas where PBO ITNs will be distributed (Table 1). Mosquito collections will be conducted to assess mosquito species composition, temporal, and spatial distribution, biting rates and times, indoor resting densities, parity rates, sporozoite rates and EIR as described in the PMI technical guidance. Previous data collected from 2017 to 2021 will be used for comparison with the 2022 data to monitor the impact of IRS and next generation ITNs.
- Support the NMCP for field entomological data collection to have a complete data set that will inform the program on the activities for the upcoming years.
- Facilitate national vector control working group meetings.
- Facilitate review of entomological monitoring data by relevant parties to inform and improve integrated vector control decision-making.
- Train and support the NMCP technicians in entomological techniques of malaria vectors.
- Work on transferring skills needed for data management, operating the insectary, and entomological monitoring at the sentinel sites through on-the-job-training and coaching.
- Contribute to the publication of the joint bulletin on malaria by the NMCP.
- Train and support NMCP leadership on reporting and using vector control data for decision making at the national level.
- Train and implement ITN durability monitoring (36month end line) in three sentinel sites (Gaoua, Orodara and Banfora).
- The project will be responsible for entomology items that require international procurement, provision of technical assistance, and ensuring the quality of work.
Success stories from PMI VectorLink Burkina Faso: